There is little that is more painful than watching your own child suffer. If your son or daughter is trapped in the confusing and frightening world of Obsessive-Compulsive Disorder, you may be feeling helpless, frustrated, and deeply worried about their future. You might be struggling to understand their strange rituals, exhausted by their constant need for reassurance, and unsure of how to help.
Please, take a breath. You are in the right place.
The most important thing for you to know is that OCD is a highly treatable condition, especially with early and correct intervention. And the second most important thing to know is this: You, as their parent, are the most powerful and essential ally your child has in their recovery.
This guide is designed to help parents in Ireland understand what OCD looks like in children and teenagers, learn the most effective ways to support them, and navigate the Irish healthcare system to get them the expert help they need.
How OCD Looks Different in Children and Teenagers
A child with OCD often doesn’t have the sophisticated language to say, “I’m having an intrusive thought about…”. Their distress manifests in their behaviour. What might look like defiance, tantrums, or quirky habits can often be the visible signs of an internal battle with OCD.
- In Younger Children (ages 5-11):
- Repetitive Questions: They may ask the same question over and over (e.g., “Are you sure the door is locked?”, “Are you sure I won’t get sick?”), seeking a specific kind of reassurance.
- Rigid Routines: Bedtime or morning routines can become extremely long, complex, and rigid. Any deviation can cause extreme distress or a “meltdown.”
- “Bad Thoughts”: They may complain of “bad thoughts” or “scary pictures” in their head that they can’t get rid of, often without being able to articulate the specific content.
- Confessing: They may feel a constant need to confess minor “wrongdoings” to a parent to relieve feelings of guilt.
- In Teenagers (ages 12-18):
- Increased Secrecy: Teenagers are often acutely aware that their thoughts and rituals are “weird.” Shame can lead them to become very secretive, performing compulsions only in their bedroom or when they think no one is watching.
- More “Adult” Themes: Obsessions can shift to more complex themes like existential fears (fear of death), scrupulosity (fear of being immoral or sinful), or harm obsessions involving sexual or violent thoughts.
- School Avoidance & Social Withdrawal: The effort of managing OCD in a busy school environment can be overwhelming, leading to school refusal. They may also withdraw from friends as they don’t have the energy to engage socially.
The Parent’s Dilemma: The Trap of “Accommodation”
As a parent, your deepest instinct is to protect your child and soothe their distress. When your child is crying with fear because their books aren’t perfectly aligned, the most natural thing in the world is to help them align the books. This is called accommodation.
Accommodation refers to any way that family members change their own behaviour to help a child avoid anxiety and perform their compulsions. It is always born from love, compassion, and a desperate desire to restore peace.
Common examples of accommodation include:
- Answering the 20th reassurance-seeking question.
- Buying special soaps or cleaning products.
- Checking the locks for your child.
- Speaking for them in social situations they are anxious about.
- Allowing your entire family’s dinner schedule to be dictated by one child’s rituals.
Here is the heartbreaking paradox of OCD: The loving accommodations you make to help your child feel better in the short term are the very things that strengthen the OCD in the long term. Every time you accommodate a ritual, you are sending your child’s brain a powerful message: “The threat is real, this ritual is necessary to keep you safe, and you are not strong enough to handle anxiety on your own.”
Your New Role: Moving from Accommodator to Coach
Recovering from OCD requires the entire family to shift their approach. Your new role is to become a warm, firm, and supportive “ERP coach” for your child. This means learning to respond in a way that validates their feelings while refusing to participate in the compulsions.
DO:
- Validate the Feeling, Not the Fear: Instead of saying, “Don’t be silly, the door is locked,” try saying, “I can see you’re feeling really scared right now. This is the OCD talking, and I know we can beat it together.”
- Externalise the OCD: Work with your child to give their OCD a funny or silly name (e.g., “the Worry Bully” or “Mr. Bossy”). This creates a separation between your child and their illness. You can then team up against it: “Mr. Bossy is telling you to wash your hands again, but we’re not going to listen to him.”
- Praise the Effort: Lavish praise on any attempt to resist a compulsion. The effort is more important than the outcome. “I am so proud of you for trying to leave the room even though it felt scary. That was so brave!”
DON’T:
- Don’t Get into Logical Debates: You cannot reason your child out of an obsession. Arguing with the OCD gives it oxygen and attention. A simple, firm response is best: “We’ve already checked that once. We’re not giving the Worry Bully any more of our time.”
- Don’t Provide Reassurance: This is one of the hardest changes to make. Gently but firmly refuse to answer the repetitive questions. You can say, “That sounds like an OCD question, and my job is to help you get stronger, so I’m not going to answer it.”
- Don’t Shame or Blame: Always remember that your child is not choosing this. It is a neurological condition. Remind them often: “This is not your fault. This is your OCD, and we are going to get the right help for it.”
Navigating the Irish System: Getting Your Child the Right Help
Getting the right diagnosis and treatment is crucial. Here is the path to follow in Ireland:
- Start with Your GP: Your family doctor is your first and most important port of call. They can assess your child’s symptoms and make a referral to the public specialist service, CAMHS (Child and Adolescent Mental Health Services), which is run by the HSE. Be aware that waiting lists for CAMHS can be long, so it’s important to start this process as soon as you are concerned.
- Explore Private Options: You can also seek a private child psychologist or therapist. It is essential to find someone with specific qualifications. Look for a professional accredited by the Psychological Society of Ireland (PSI) or the Irish Association for Counselling and Psychotherapy (IACP) who explicitly states they have training and experience in treating paediatric OCD with ERP.
- Work with the School: Inform your child’s school about their diagnosis. The school’s guidance counsellor and the National Educational Psychological Service (NEPS) can be valuable resources. A child with severe OCD may be entitled to “reasonable accommodations” to help them manage their school day.
The gold-standard treatment for childhood OCD is Family-Based ERP. This means the therapist will not just work with your child; they will work with you. They will teach you how to be an effective ERP coach, how to systematically withdraw your accommodations, and how to create a supportive home environment that encourages bravery and resists compulsions. You are an integral part of the treatment team.
Return to our main guide: Obsessive-Compulsive Disorder (OCD): The Definitive Guide for Ireland